Individual
JERMAYNE TERRELL BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8786 GOODWOOD BLVD, BATON ROUGE, LA 70806-7917
(337) 254-8990
Mailing address
6894 VINEYARD DR, BATON ROUGE, LA 70812-2151
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/07/2017
Last updated
07/07/2017
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